Many types of feeding catheters have been developed to provide gastric or intestinal access for patients who cannot meet their nutritional needs eating by mouth. These catheters have been designed and constructed to allow fixed length tubes for insertion through a stoma in the patient's abdomen. These devices are made to accommodate the typical adult patient anatomical sizes. They do not accommodate pediatric patients, adult patients who have undergone surgical procedures which have altered their small intestine, or those patients who suffer intestinal tract congenital abnormalities. Frequently, clinical practitioners have tried to overcome these shortcomings by inserting two tubes through the patient's abdominal stoma: one tube of the appropriate size for gastric feeding, and a second tube sized for the patient's jejunal anatomical structure.
U.S. Pat. No. 4,666,433 (S. K. Parks), U.S. Pat. No. 4,701,163 (S. K. Parks), and U.S. Pat. No. 4,701,162 (P. Rosenberg) all show such a device for gastric feeding. All of these existing tubes require a separate jejunal catheter to be placed alongside the gastric feeding device. During placement of any of the above existing tubes, the patient's stoma must be temporarily or permanently enlarged to allow both individual tubes to pass through the small abdominal opening. This is particularly aggravating in small pediatric patients. After placement, during extended use, all of these two tube methods are subject to extensive leakage of gastric contents. This is primarily due to the inability of these combinations of separate devices to seal the gastric stoma. Patients using these devices require significant routine nursing care to treat the caustic effects of stomach acid leaking onto the skin. These two tube through the stoma methods also require the patient to undergo repeated surgical procedures to excise granuloma growth at the stoma site. This granuloma growth is caused by the side to side and rotational movements of the two tubes within the stoma opening. These problems with the existing devices require the patient to undergo several costly follow-up surgical procedures and continual nursing care over extended nutritional support periods. The existing devices all require this additional medical, surgical and nursing care in the hospital setting and make home care of these patients very demanding. This combination of problems with the existing devices is particularly serious for small pediatric patients in marginal medical condition.
Gastrointestinal or enteral feeding devices currently available under U.S. Pat. Nos. 4,685,901 and 5,234,417 (S. K. Parks), have attempted to solve the previously mentioned leakage problems by employing a fixed length jejunal tube as an integral part of the device. These devices, however, do not allow clinical practitioners to adjust the length of the jejunal lumen to meet the needs of individual pediatric, post-surgical adult patients or those with congenital abnormalities. The Park devices employ only a fixed length non-adjustable tube. This makes the Park tube unusable in situations where the patient's intestinal anatomy does not match the standard length tubes currently available. This is particularly critical in pediatric and post-surgical adult patients.